Duke Cancer Institute's Gastrointestinal Cancer disease group applies the findings of our labs to our clinical practices — continually improving the outcomes of our patients.
We treat colorectal cancer (colon and rectal), esophageal cancer, stomach (gastric) cancer, anal cancer, liver cancer, pancreatic cancer, bile duct cancer (cholangiocarcinoma) and gallbladder cancer, and neuroendocrine Cancer .
Patients with GI cancers benefit from our refined approaches to risk assessment, advances to improve responses to existing treatments, and development of more effective treatments.
Our physicians specialize in the treatment of aggressive and complex GI cancers. The best approach for our patients depends on the tumor type, stage, and personal goals.
One or more of the following therapies may be recommended:
- Radiation Therapy
- Interventional radiology
- Targeted Therapies
Research Focus Areas
Our Gastrointestinal Cancer disease group is advancing translational research to bring about new treatments, improve the effectiveness of current treatments, and prevent or lessen treatment side effects.
Preclinical & Translational Research
Our physician scientists bring together clinical, translational and basic research to identify mechanisms of sensitivity, resistance, and toxicity to anti-cancer therapies.
Gerald Blobe, MD, PhD, is the lead physician-scientist engaged in preclinical research.
David Hsu, MD, PhD; Michael Morse, MD; Brent Hanks, MD, PhD; and Nicholas Devito, MD; are physician-scientists engaged in translational research. Andrew Nixon, PhD, is the lead scientist engaged in translational research.
- VRP- and Ad-HER2, Plasmid-HER3, VRP-CEA
- Combinations with anti-PD-1 and anti-CTLA4 antibodies
- Preclinical to clinical translation of HSP90 targeting strategies
- SMAC mimetics + antibodies (cetuximab)
- SMAC mimetics plus T cell therapies
- SMAC mimetics plus cancer vaccines
Led by Brent Hanks, MD, PhD, this lab utilizes genetically engineered tumor model systems as well as clinical specimens to:
- Understand the mechanisms that cancers utilize to suppress the generation of anti-tumor immunity
- To characterize the regulatory pathways that suppress the efficacy of cancer immunotherapy
The Hanks Lab works to develop novel strategies to enhance the efficacy of checkpoint inhibitor and vaccine immunotherapy while also developing predictive biomarkers to better guide the management of cancer patients with immunotherapeutic agents. The lab's work in GI oncology is currently focused on understanding the role of autocrine and paracrine Wnt signaling in the establishment of immune tolerance and immunotherapy resistance.
The Hsu Lab
Led by David Hsu, MD, PhD, this lab is engaged in:
- Identification, characterization and validation of novel drug targets for colorectal cancer and other GI cancers using Patient Derived Models of Cancer (PDMC), including targeting key receptors (FGFR, TK1) in CRC PDMCs and Rapid Organoid Therapeutic Assay (ROTA) to guide therapy in colorectal cancer
- Epigenomic Reprogramming in Patient Derived Models of Colorectal Cancer (U01), including defining the role of epigenetic profiling (ATAC-seq) of colorectal cancer in drug resistance and the immune system, and developing a humanized patient-derived-xenograft model using CD34+ cells isolated from matched patients
The Phase I Biomarker Laboratory, directed by Andrew Nixon, PhD, has been appointed as a Molecular Reference Laboratory for the Alliance oncology cooperative group, a national clinical trial research group sponsored by the National Cancer Institute.
Clinical & Correlative Research
We have an experienced team made up of physician-scientists, nurses, and in-patient staff as well as specialists engaged in protocol development and clinical trial registration.
Our main foci of clinical research are in esophageal/GE/gastric cancer (Hope Uronis, MD); hepatobiliary cancers (Michael Morse, MD); neuroendocrine cancer (Michael Morse, MD); pancreatic cancer (James Abbruzzese, MD, and Niharika Mettu, MD); and colorectal cancer (John Strickler, MD, David Hsu, MD, PhD, and Yousuf Zafar, MD, MHS).
Topics of correlative investigation include:
- Multi-analyte ELISA for soluble biomarkers of sensitivity/ resistance (Nixon Lab)
- Profiling liver metastases vs primary (CRC) – (Mettu/Nixon Lab)
- cfDNA profiling EGFR Ab refractory metastatic CRC to identify and treat genomic markers of sensitivity/ resistance
- Molecular profiling to identify mechanisms of immunotherapy resistance
- Immune cell phenotyping
- T-cell repertoire sequencing
Health Services Research
Our Center for Applied Cancer Health Policy, led by physician-scientist Yousuf Zafar, MD, MHS, investigates affordability and value of care, oncology reimbursement and care redesign, and behavioral science in cost and value.
Select active studies include:
- NCI-grant funded RCT linking patients to financial assistance programs (N=200)
- Development of patient-facing app to reduce treatment-related financial burden
- Analysis of Affordable Care Act insurance plans nationwide to determine patterns of cost sharing
We collaborate in health services research with Duke University’s Margolis Center for Health Policy, Duke Forge (Health Data Science Center), Fuqua School of Business, and the Sanford School of Public Policy.
We have many gastrointestinal cancer trials open, including for colorectal cancer and cancers of the stomach, esophagus and other digestive organs.
If you need additional information about any of the trials listed or would like to inquire about other open trials, please contact the Gastrointestinal (GI) Clinical Trials Office at 919.668.1861.